Absorbable sutures in microvascular anastomosis

Absorbable sutures have obvious theoretical advantages in vascular anastomosis. These include the absence of permanent foreign bodies, a greater integrity in the healed anastomosis and no impediment to growth in the younger patient. In spite of the successful use of catgut in vascular anastomosis reported by Aberdeen in the 196Os, absorbable sutures have not been used in vascular repair until the recent advent of synthetic absorbable material. In this study 10/O nylon on a 75 micron needle was compared with monofilament polyglycolidepoly-lactide (Vicryl (R)) of the same gauge in anastomoses of the femoral arteries. The anastomosis was made with nylon on one side and Vicryl (R) on the other. The anastomoses were examined microscopically at periods of 3, 8, 28 and 56 days and by light and scanning electron microscopy. Three of the 20 Vicryl (R) and one of the nylon anastomoses were wholly or partially thrombosed at post-mortem. The histological results showed nylon and Vicryl (R) to be similar in the early stages of repair, (3 and 8 days), but suggested that absorbability especially with a low level of tissue reaction, confers advantages at the longer periods (28 and 56 days). Good neo-intimal surfaces were observed at the longer times with both sutures.